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Previous issue date: 2013-03-22 / Objective: To determine the risk factors related to the development of stroke in patients undergoing cardiac surgery. Methods: A historical cohort study. We included 4626 patients aged ≥ 18 years who underwent coronary artery bypass surgery, heart valve replacement surgery alone or combined with CABG between January 1996 and December 2011. The relationship between risk predictors and stroke was assessed by logistic regression model with a significance level of 0.05. Results: The incidence of stroke was 3% in the overall sample. After logistic regression found the following risk predictors for stroke: age 50-65 years (OR=2.11 95% CI 1.05-4.23 p=0.036) and age ≥66 years (OR=3.22 95% CI 1.6-6.47 p=0.001), urgent and emergency surgery (OR=2.03 95% CI 1.20-3.45 p=0.008), aortic valve disease (OR=2.32 95% CI 1.18-4.56 p=0.014), atrial fibrillation (OR=1.88 95% CI 1.05-3.34 p=0.032), peripheral artery disease (OR=1.81 95% CI 1.13-2.92 p=0.014), history of stroke (OR=3.42 95% CI 2.19-5.35 p<0.001) and cardiopulmonary bypass time >110 minutes (OR=1.71 95% CI 1.16-2.53 p=0.007). The mortality was 31.9% in the stroke group and 8.5% in the control group (OR=5.06 95% CI 3.5-7.33 p<0.001). Conclusion: The study identified the following risk predictors for stroke after cardiac surgery: age, urgent and emergency surgery, aortic valve disease, atrial fibrillation, peripheral artery disease, history of cerebrovascular disease and cardiopulmonary bypass time> 110 minutes. / Objetivos: Determinar os preditores de risco relacionados ao desenvolvimento de acidente vascular cerebral em pacientes que realizaram cirurgia card?aca. M?todos: Estudo de coorte hist?rico. Inclu?mos 4626 pacientes com idade ≥ 18 anos submetidos ? cirurgia de revasculariza??o do mioc?rdio, cirurgia card?aca valvar isolada ou cirurgia valvar associada com revasculariza??o do mioc?rdio, de janeiro de 1996 e dezembro de 2011. A rela??o entre os preditores de risco e o acidente vascular cerebral, foi avaliada por modelo de regress?o log?stica com n?vel de signific?ncia de 0,05. Resultados: A incid?ncia de acidente vascular cerebral foi 3% na amostra total. A an?lise multivariada identificou como preditores de risco para o acidente vascular cerebral: idade 50-65 anos (OR=2,11 95% IC 1,05-4,23 p=0,036) e idade ≥ 66 anos (OR=3,22 95% IC 1,6-6,47 p=0,001), cirurgia de urg?ncia/emerg?ncia (OR=2,03 95% IC 1,20-3,45 p=0,008), valvulopatia a?rtica (OR=2,32 95% IC 1,18-4,56 p=0,014), fibrila??o atrial (OR=1,88 95% IC 1,05-3,34 p=0,032), doen?a arterial obstrutiva perif?rica (OR=1,81 95% IC 1,13-2,92 p=0,014), hist?ria de doen?a cerebrovascular (OR=3,42 95% IC 2,19-5,35 p<0,001) e tempo de circula??o extracorp?rea >110 minutos (OR=1,71 95% IC 1,16-2,53 p=0,007). A mortalidade foi 31,9% nos pacientes que sofreram AVC e 8,5% nos sem AVC (OR=5,06 95% IC 3,5-7,33 p<0,001). Conclus?o: Idade, cirurgia de urg?ncia/emerg?ncia, doen?a de valva a?rtica, fibrila??o atrial, doen?a arterial obstrutiva perif?rica, hist?ria de doen?a cerebrovascular e tempo de circula??o extracorp?rea >110 minutos foram preditores independentes para o desenvolvimento de AVC intra-hospitalar, em pacientes submetidos ? cirurgia card?aca.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/1732 |
| Date | 22 March 2013 |
| Creators | Santos, Handerson Nunes dos |
| Contributors | Bodanese, Luiz Carlos |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, BR, Faculdade de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 600, -8624664729441623247 |
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